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NPI Code Detail

MEDICARE: SABI ILLANGAKOON

MEDICARE: SABI ILLANGAKOON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician21619SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275578833
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABI ILLANGAKOON
Provider Business Mailing Address
First Line : PO BOX 485
Second Line :
City : COLUMBIA
State : SC
Zip : 29202-0485
Country : US
Telephone Number : 803-898-8405
Fax Number :
Provider Business Practice Location Address
First Line : 2015 MARION ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2113
Country : US
Telephone Number : 803-898-0123
Fax Number : 803-898-4892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 06/04/2012

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1396839569 — MS. PENELOPE MORTON WILLIAMS M.A.
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1285716464 — MRS. JANE ELIZABETH GARMANY R.N.
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1073696316 — MS. LAN L BONNO LEBOZEC LPC.,CRC.,CFAE
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Directions to “ SABI ILLANGAKOON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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